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Does masked hypertension impact left ventricular deformation?

Marijana Tadic1, Cesare Cuspidi2, Vladan Vukomanovic3

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Summary

Masked hypertension (MH) significantly impairs left ventricular (LV) deformation, showing reduced strain compared to normotensive and sustained hypertensive individuals. Blood pressure levels correlate with these LV mechanical changes.

Keywords:
Arterial hypertensionfunctionleft ventricular structuremechanics

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Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Masked hypertension (MH) presents normal clinic blood pressure (BP) but elevated 24-hour BP.
  • Left ventricular (LV) deformation is a sensitive indicator of cardiovascular health.
  • Understanding LV mechanics in MH is crucial for early detection and management.

Purpose of the Study:

  • To compare LV deformation in subjects with MH versus normotensive and sustained hypertensive patients.
  • To investigate the association between BP and LV mechanics in different hypertensive groups.
  • To assess the impact of MH on LV deformation using multilayer strain analysis.

Main Methods:

  • Cross-sectional study of 185 untreated subjects.
  • 24-hour ambulatory BP monitoring and two-dimensional echocardiography (2DE).
  • Multilayer strain analysis of LV longitudinal, circumferential, and radial deformation.

Main Results:

  • LV longitudinal and circumferential strains significantly decreased from normotensive controls to MH and sustained hypertensive patients.
  • Endocardial and midmyocardial LV strains showed progressive decline across groups.
  • Clinic and 24-hour systolic BP were independently associated with reduced LV longitudinal and circumferential strains.

Conclusions:

  • Masked hypertension significantly affects LV deformation, detectable by 2DE strain analysis.
  • LV mechanics are compromised in MH, correlating with BP levels.
  • Comprehensive 2DE strain analysis is valuable for evaluating LV function in hypertensive individuals.